Carga sanitaria y económica del consumo de bebidas azucaradas en Brasil

Perelli, Lucas; Alcaraz, Andrea; Vianna, Cid Manso de Mello; Espinola, Natalia; Cairoli, Federico Rodriguez; Bardach, Ariel; Palacios, Alfredo; Balan, Dario; Johns, Paula; Augustovski, Federico; Pichón-Rivière, Andrés

Lucas Perelli

contributed to the data acquisition

analysis and interpretation, and writing

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0001-6444-4143

Andrea Alcaraz

contributed to the study design

data analysis, writing, and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0002-4260-8239

Cid Manso de Mello Vianna

contributed to the data acquisition and review

approved the final version

Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil.

http://orcid.org/0000-0003-0252-1144

Natalia Espinola

contributed to the model conceptualization

data acquisition, analysis and interpretation

writing, and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0001-5511-3561

Federico Rodriguez Cairoli

contributed to the data acquisition

analysis and interpretation

writing, and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0002-3029-4439

Ariel Bardach

contributed to the data interpretation and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.

http://orcid.org/0000-0003-4437-0073

Alfredo Palacios

contributed to the data interpretation and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

Centre for Health Economics, University of York, York, U.K.

http://orcid.org/0000-0001-7684-0880

Dario Balan

contributed to the data interpretation and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0002-3465-3304

Paula Johns

contributed to the data interpretation and review

approved the final version

ACT Promoção da Saúde, Rio de Janeiro, Brasil.

http://orcid.org/0000-0002-0868-0894

Federico Augustovski

contributed to the data interpretation and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0002-2914-5022

Andrés Pichón-Rivière

contributed to the study design, data analysis

writing, and review

approved the final version

Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina.

http://orcid.org/0000-0001-6052-025X

Correspondence
L. Perelli Instituto de Efectividad Clínica y Sanitaria. Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina. perellilucas@gmail.com

Additional information

ORCID: Lucas Perelli (0000-0001-6444-4143); Andrea Alcaraz (0000-0002-4260-8239); Cid Manso de Mello Vianna (0000-0003-0252-1144); Natalia Espinola (0000-0001-5511-3561); Federico Rodriguez Cairoli (0000-0002-3029-4439); Ariel Bardach (0000-0003-4437-0073); Alfredo Palacios (0000-0001-7684-0880); Dario Balan (0000-0002-3465-3304); Paula Johns (0000-0002-0868-0894); Federico Augustovski (0000-0002-2914-5022); Andrés Pichón-Rivière (0000-0001-6052-025X).

Gender/Age group (years)	Population (millions) *	SSBs consumption (servings mean) **	Overweight (%) **	Obesity grade 1 (%) **	Obesity grade 2 (%) **	Obesity grade 3 (%) **
Adults
Female
18-44	45.0	0.8	27.57	10.00	2.62	1.10
45-64	22.8	0.5	37.26	16.04	4.67	1.76
> 65	10.0	0.3	37.61	15.87	4.08	1.55
Subtotal	77.8	0.5	33.62	13.68	3.75	1.41
Male
18-44	44.0	1.08	38.44	14.19	3.54	1.44
45-64	21.2	0.6	45.69	16.85	3.87	1.17
> 65	7.0	0.3	42.00	13.54	2.23	0.63
Subtotal	72.2	0.6	41.70	14,60	3.36	1.15
Both
18-44	89.0	0.93	33.03	11.58	3.08	1.20
45-64	44.0	0.5	41.23	16.39	4.19	1.49
> 65	17.0	0.3	39.61	14.18	3.41	1.09
Subtotal	150.0	0.6	37.70	14.14	3.55	1.28
Children and teenagers
Female
0-4	7.2	0.5	7.60	7.40
5-17	19.8	1.17	6.58	2.03
Subtotal	27.0	1.0	7.10	4.70
Male
0-4	7.5	0.4	7.60	8.30
5-17	20.6	1.29	8.37	3.60
Subtotal	28.1	1.1	8.00	4.30
Both
0-4	14.7	0.4	7.60	7.80
5-17	40.4	1.21	7.48	2.81
Subtotal	55.1	1.0	7.50	6.40

Diseases	Incidence rate *	Prevalence rate *	Mortality rate *	Incident event costs (USD)	Costs of 2+ year per prevalent event (USD)
Asthma	1,021.77	4,665.80	1.16	1,453.80
Atrial fibrillation and flutter	46.09	640.80	4.840	960.04
Chronic kidney diseases	268.62	7,337.15	16.10	1,504.69
Colon and rectum cancer	16.30	69.600	10.28	14,699.91	1,918.04
Dementia	94.50	603.70	35.50	1,996.65
Type 2 diabetes mellitus	195.70	3,834.20	20.82	1,635.20
Esophageal cancer	4.60	6.57	4.84	22,403.94	15,174.22
Gallbladder and biliary diseases	69.30	433.60	2.92	271.46
Gallbladder and biliary tract cancer	2.20	1.60	2.34	18,136.41	12,415.07
Hypertensive heart disease	46.90	211.50	10.60	1,122.53
Intracerebral hemorrhage	33.90	189.70	27.90	1,683.61
Ischemic heart disease	78.80	1,563.70	80.00	6,210.62	345.45
Ischemic stroke	67.21	856.20	22.60	1,683.61
Kidney cancer	44,717.00	28.900	1.77	19,204.09	13,450.09
Low back pain	4,528.15	11,018.36	NA	16.55
Osteoarthritis	160.48	3,142.85	NA	372.66
Subarachnoid hemorrhage	16.44	144.18	6.06	5,528.82
Uterine cancer	3.59	25.78	1.13	9,094.23	898.76

Condition	Women		Men		Both
Condition	Total attributable (95%CI)	%	Total attributable (95%CI)	%	Total attributable (95%CI)	%
Overweight and obesity (< 18 years)
Events	331,630 (172,447-461,495)	11.00	391,009 (203,324-543,502)	7.00	722,639 (381,499-1,006,604)	11.00
Direct medical costs (USD million)	13.33 (7.2-18.3)	14.00	8.42 (4.54-11.6)	10.00	21.74 (11.7-30)	12.00
Overweight and obesity (adults)
Events	829,703 (613,980-1,028,204)	2.20	1,389,465 (102,824-1,806,304)	3.20	2,219,168 (1,647,187-2,907,689)	2.70
Direct medical costs (USD million)	37.24 (27.7-54.7)	3.00	75.3 (56-111)	6.70	112.54 (83.8-165.7)	4.80
Type 2 diabetes mellitus
Deaths	2,672 (1,054-4,546)	10.90	2,591 (1,117-4,195)	13.60	5,225 (2,181-8,511)	12.07
Events	688,369 (295,545-1,041,745)	15.00	727,013 (323,894-1,089,068)	19.00	1,415,383 (624,131-2,129,006)	17.00
Direct medical costs (USD million)	1,126 (506.7-1,722.78)	15.20	1,189 (503-1,819)	18.00	2,265 (1,021-3,482)	16.30
Heart diseases *
Deaths	1,444 (605-2,441)	2.60	2,220 (1,018-3,581)	3.35	3,664 (1,654-5,910)	3.02
Events	51,967 (23,157-83,174)	2.93	87,365 (41,486-138,275)	3.76	139,332 (65,165-217,649)	3.40
Direct medical costs (USD million)	81 (37.6-127)	2.90	132 (61.3-206)	3.07	213 (99-334)	3.30
Cerebrovascular disease
Deaths	1,533 (659-2,574)	2.65	1,945 (893-3,107)	3.37	3,479 (1,568-5,593)	3.00
Events	42,880 (19,646-67,369)	3.20	49,743 (23,776-78,421)	3.96	92,938 (43,293-143,770)	3.58
Direct medical costs (USD million)	104 (48.1-160)	3.35	110 (50.8-169.6)	4.00	214 (99-330)	3.60
Other conditions **
Deaths	260 (161-394)	0.22	313 (194-474)	0.35	573 (354-868)	0.27
Events	96,498 (60,996-149,951)	0.56	82,753 (52,308-128,592)	0.46	179,251 (113,304-278,544)	0.53
Direct medical costs (USD million)	88 (55.5-133.5)	0.30	87 (54-132)	0.04	175 (110-265)	0.33
Total
Deaths	5,910 (3,247-8,940)	2.60	7,032 (4,310-10,175)	3.36	12,942 (8,070-18,500)	2.96
Events	857,242 (203,122-1,462,143)	2.02	957,243 (259,976-1,576,838)	2.68	1,814,485 (463,098-3,038,981)	2.32
Direct medical costs (USD million)	1,399 (801-1,999.1)	3.80	1,517 (869.42-5,813.48)	5.30	2,865 (1,642-4,094)	4.50

P A F = \frac{\int_{i = 1}^{m a x} P_{i} {R R}_{i} - \int_{i = 1}^{m a x} P_{i}^{'} {R R}_{i}}{\int_{i = 1}^{m a x} P_{i} {R R}_{i}}

[1] Correspondence
L. Perelli Instituto de Efectividad Clínica y Sanitaria. Dr. Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina. perellilucas@gmail.com

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Carga sanitaria y económica del consumo de bebidas azucaradas en Brasil

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